Back to 5 mg and still not doing the trick!

[Lafontainepam1]

Doing so well below 5 mg for a couple years, finally at 4/3 doing the slow then a trip to Az for 2 weeks, my 5 mg is not helping that much, never been this way in years, HELP!!!!!!

[Celtic PMRGCAuk volunteer]

Then it sounds as though you need to go a little higher, perhaps to 7.5, to get control of the inflammation. If a flare is severe, it is often recommended to increase by 5mg. In fact, on the advice of my wonderful rheumy, I had to go as high as 10mg during a flare around the 5 down to 3mg dose - it worked and under his guidance I was fairly quickly able to return back down to 5mg by alternating doses of 10/7.5 followed by 7/5.5. Once back at 5mg, he kept me there for 5-6 months. Hopefully, 7.5mg will prove successful for you

[Lafontainepam1 in reply to Celtic]

Thank you so much I will do it right away!😊

[Lafontainepam1 in reply to Lafontainepam1]

Instead of splitting it, I added 3, so that has me at 8. I pray I start to feel better. How long do I stay on it, and how do I go back to 4-3?

[Celtic PMRGCAuk volunteer in reply to Lafontainepam1]

If the increase to 8mg is going to work, you should notice an improvement fairly quickly, and more than likely by tomorrow. How long you need to remain there can vary from person to person. My experience was to remain at the increased dose for 2 weeks before reducing but I had embarked on a much higher increase than you. As you have only increased by 3mg, then I think you would be wise to take it fairly slowly going back down, say by just half a mg at first to test the water. It's very much a case of finding what works for you but, hopefully, if you were fine previously at 5mg then you should be able to continue reducing in half mg decrements every couple of weeks back down to 5. Don't be tempted to embark again on the slow reduction back to 4 from there for a good month or so to ensure that the inflammation has stabilised. If you are someone who had raised markers of inflammation at diagnosis, then repeated blood tests can be used as a guide along with your symptoms. Importantly, take things easy whilst you are reducing back down - important following any reduction in dose but even more so following a flare.

[Lafontainepam1 in reply to Celtic]

Thank you so much for the fast response. I was doing the slow 4-3 dose and only a couple weeks from a flat 3. It is so discouraging but that certainly goes with this, I should be use to it after all these years. I hope tomorrow is a better day. Bless you for helping me, like we say, no one knows how we feel but all of us here!💞💕

[PMRpro Ambassador]

Celtic said it - add 5mg to where you flared until the symptoms are under control. Then you can go back to just above where you flared fairly quickly as she describes. The sooner you do that, the less worse the flare will be.

[Lafontainepam1 in reply to PMRpro]

Thank you, I will do it.😊

[Lafontainepam1]

It has been almost 2 weeks since my flare up. I had reached 8 mg of Pred. Before I felt back to normal. As of today I started taking 7 instead of 8. How quickly can I reduce?

[HeronNS in reply to Lafontainepam1]

That, Lafontainepam, will have to be up to you. I gather from the responses above that generally people can reduce from treating a flare more quickly than when they were doing their original taper. If it were me I would stay at the higher dose for a week or two, provided I continued to feel well, then taper using the method Celtic and PMRPro suggest, again, by reducing the dose every couple of weeks. Of course you would want to stop the taper, or slow it down, if you felt your pains returning.

[Lafontainepam1]

Thank you so much for the advice. Since I was only on the 8mg for a week I have dropped to 7mg and will hold for a week then see what happens. If all is good I will drop to 6mg the following week. Once I get to 5mg I will stay on that for a few months just to be safe. With me the emotional traumas effect me the worst!

[HeronNS in reply to Lafontainepam1]

I can really relate to that. There was a local news item that really upset me around the time I was set to start tapering from 8 mg to 7. I could almost literally feel my body go up in flames. I ended up taking an extra mg the next morning, then back down to 8. I started the taper by going only to 7.5 but at the halfway point felt well enough to start a 7.5 to 7 taper. But at 7 I appear to be needing to stay for a while. Maybe after the upheaval of Christmas and New Year is over I'll try 6.5. I hope you get back on track quickly.

[Lafontainepam1 in reply to HeronNS]

Me too. It's soooo disappointing to get so close the have to go back up. At one time, about a year and half ago I was at 2 and felt wonderful, stayed for a few months and then the holidays came, and I fell!! At least I know many have had similar problems, I don't feel alone anymore, what a blessing to have loving support from so many!😊

[HeronNS in reply to Lafontainepam1]

You know, you are right. And for all the worry prednisone causes us (isn't that why we are all on these forums, because if prednisone didn't cause us problems we'd have little need to be here) prednisone is what has given us back our lives. 🐉❤